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Home My WebLink AboutPR17-8186C z a [ c F CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS ,:4 > (9D9) 839-7020 Fax- (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamotidbalr.com building@diamondbarca.gov OB SITE ADDRESS 0 I t - oA"� k_ t ,°'.. APN LOT TRACT OWNER ADDRESS- 0ITY [ "� rrzr illo 7 a TEL. APPLICANT TEL. CONTRACTOR s�..,,': Q✓ a ADDRESSf ¢.r CITY/ f a IP TEL Caw J l r ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION E hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason{s) indicated below by the aheckmark(s), I have placed next to the applicable item{sj [Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any structure, prior to his issuance, also requires the applicant fur the permit be file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law {Chapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of Pat more than five hundred dollars ($500) U I, as owner of the property, or my employees with wages as their sate compensation, will do U all of or (_) portions of the work, and The structure is not Intended or offered for safe (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or Improves the property, provided that Inc, improvements are not intended or offered for sale. If however, the building or Improvement Is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or Improved for the purpose of sale). LT I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for the projects with a llcensed Contractor pursuanttothe Contractors' State License Law.). L) I am exempt from licensure under the Contractor's State License law for the fallowing reason(s): Date: sign By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this pormit,i cannot legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the j applicable law, Section 7044 of the Business and Professions Code is available upon request when this application is submitted or attire following Web site: httplwvrw.leginfe.ca,gov/calaw,html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect LICENSE CLASS; g 7 LIC. NO.: _ w -� EXP. DATE:, CONTRACTOR: - .J IL2T WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Solt -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. a I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the workforwhich this permit Is Issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER �`!..'_,.sJ—�°. r.�:s E`s :•e'f. ,r�,e.r C! �.."'.r G:'.o'.P <<.d=.' 3 POLICY NUMBER �. _ :;3 (1HIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). j I certify that in The performance of the workfor which this permit Is Issued, € shall not employ any person In any manner so as to �i become subject to the Wo(ker's Compensation laws of California. And agree that If I should homme subject to the Worker's JCompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those previsions DATE: APPLICANT: WARNING: Fa€Iufe to secure Worker's Compensation coverage Is unlawful, and shall subject an employer to criminal u penalties and civil fines up to one hundred thousand dollars (51 00,000), in addition to the cost of the compensation, L damages as provided for In section 3708 of the Taber cods, interest, and attorney's fees CONSTRUCTION LENDING AGENCY u I hereby affirm under penalty of perjury that there is a Construction Landing Agency for the performance of the work for which this permit is Issued (Sec, 3097, Clv, C.), y LENDER'S NAME: LENDER'S ADDRESS: L I certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws rotating to building construction, and hereby authorize representatives of thls county to enter upon the above-mentioned property for Inspection purposes. 4 PERF II�ME (PRINT) n 4 _.i_ E SIGNATA OF PERMITTEE DATE APPLICATION DATE: V-1 PIC# gg ISSUE DATE: �� PERMIT# : P� TYPE CONST. OCC GROUP: Scope of Work Ice /"?I a wuF # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT- FACTOR PSF All AREAIVALUATION SFR/ADD/REM Garage/Carport LO Patio/Deck w '1 Pool/Spa ZRe -Roof � Commercial valuation: Adj. Area: QUANTITY DESCRIPTION FEE J U U u� w cs J a d U_ L) U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: ® 2 MECHANICAL: INSPECTION FEE: ISSUANCE: 0� SMTP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES l 17 COMMENTS: PIC: PAID BY: VALIDATION: RECEIPT # PAID EIY: VALIDATION: V. WHITE — Department Copy, YELLOW Finance Copy, PINK—Assessor Copy CITY ! NI INSPECTION SETBACK/ LETTER " TRACT AND LEDGER FOOTAGS FORMS- SLAB UG. PLUMBING SWITClf (:.EAR _ — COMMERCIAL HOOD T -BAR UG.ELECTRICAL] INTER(,t:@ TER HOT MOP/SHOWERPAN _ SEPTIC/CESSPOOL ESSPOOL HERS RFPORT RECDVF D DEMOLJ71{1N ROOF DRAINS ROUGH CONDUIT LIFER GROUND SEWER LATFRAI_ MAIN WATER I INE SEWER CLEANOUT ROOF SHEATI IING FLOOR SHEA I LNG SHEAR WALLS EXTERIOR POOL15PA ROUGH PLUMBING ROUGH EI ECTRICAL SHEAR WALLS INTERIOR FRAMINGNENTTNG GAS METER RELEASE~ 51'fCIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL. ELECTRICAL PLUMBING LUMBING _ ....... T.C. of OCCUPANCY CERT. of OCCUPANCY COMMENTS: S: ROUGH MECHANICAL ROUGH MECHANPCAL ROUGH ELECTRICAL W( ) C () ROUGH PLUMBING _ GAS TEST PREGUNfTE INSULATION WA! I POOL PRE DECK BONDING INSULATION CEII ING P -TRAP FENCE 1 GATE! ALARM FINAL PO0L DRYWALL (-ATH (PRE) I.Ai"H EXTERIOR WALLS: WALL FOOTING/STEEL, No WALL 5TT-LEL. 1 () 2 OLIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL __. J ATH INTERIOR GAS TESTSr SCRATCH COAT ELICTRIC METER RELEASE GAS METER RELEASE~ 51'fCIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL. ELECTRICAL PLUMBING LUMBING _ ....... T.C. of OCCUPANCY CERT. of OCCUPANCY COMMENTS: S: RD. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT .... .......... FINAL PLANNING FINAL ENGINEERING/ p1N FINAL COMMUNITY SERVICES FINIAL HEALTH DEPT, Z FINAL INDUSTRIAL WASTE _..